Therese Andrews

Pulled between contradictory expectations: Norwegian mother/child service and the ‘new’ public health discourse

Abstract In public health discourses in Western societies from the late 1970s onwards, redistribution of power from health professionals to individuals has been defined as a key strategy to foster what is called ‘healthy citizens’. The idea of changing the power relations between ‘experts’ and ‘non-experts’ by ‘empowering’ the latter, however, has not been problematized within the ‘new’ public health literature to any real extent. The present paper focuses on the mother/child service in Norway, and the discussion touches on some of the challenges and tensions that arise when the rhetoric of such notions as ‘empowerment’ is put into practice. This study indicates that the ‘new’ public health discourse is not in harmony with the problematic everyday life of the health service. The analysis is based on qualitative data drawn from interviews with public health nurses.

Medicalized mothering: experiences with breastfeeding in Canada and Norway

This paper explores infant feeding practices and experiences of mothers in Canada and Norway, two countries where breastfeeding rates are relatively high. Based on interviews with 33 Canadian mothers and 27 Norwegian mothers, we also examine how mothers feel, think and talk about their infant feeding decisions and experiences, and examine similarities and divergences across their stories. Our findings reveal that infant feeding is very much organized according to the logic of the broader medical discourse, a finding which lends support to arguments that contemporary parenthood is characterized by a process of increasing medicalization. Our findings also reveal the existence of a broader culture of pressure, competition, judgement and surveillance regarding breastfeeding, suggesting that the high breastfeeding rates in these two countries are not merely a result of favourable structural conditions, but also of strong cultural expectations towards breastfeeding. We discuss our findings in connection with the broader argument that medical discourses and health professionals are becoming the primary authorities and moral gatekeepers of contemporary parenthood.

Contradictory discourses of health promotion and disease prevention in the educational curriculum of Norwegian public health nursing: a critical discourse analysis.

Aims: Health care is under constant change creating new and demanding tasks for public health nurses. The curriculum for public health nursing students is controlled by governmental directives that decide the structure and content of their education. This paper analyses manifest and latent discourses in the curriculum, in order to reveal underlying governmental principles for how public health nurses should promote health and prevent diseases. Methods: A critical discourse analysis of the Norwegian public health nursing curriculum was conducted. Results: The study indicates i) ‘a competing biomedical and social-scientific knowledge-discourse’, with biomedical knowledge dominating the content of the curriculum; ii) ‘a paternalistic meta-discourse’, referring to an underlying paternalistic ideology despite a clear focus on user participation; and iii) ‘a hegemonic individual discourse’. Even though the curriculum stipulates that public health nurses should work at both an individual and a societal level, there is very little population focus in the text. Conclusions: Recent political documents concerning public health nursing focus more on health promotion, however, this is not sufficiently explicit in the curriculum. The lack of emphasis on social scientific knowledge, and the blurred empowerment and population perspective in the curriculum, can lead to less emphasis on health promotion work in public health nursing education and practice. The curriculum should be revised in order to meet the recent governmental expectations.

Symbols and Meanings in Breast Cancer Awareness Campaigns

This article examines symbols and meanings in breast cancer awareness campaigns, and the ways in which multifarious actors draw attention to the disease. We discuss what the various campaigns and initiatives can indicate, above and beyond creating breast cancer awareness. Our data stem from sources such as printed material, the Internet, and events. From these sources we have singled out and explored objects, text, and visual expressions, looking in particular for metaphors and symbolic aspects. In this article we present six “images” indicating the underlying patterns that we found. We have called the images Re-enchantment of femininity, Infantilization, Corporate profit-making, Objectification, Transgression of boundaries, and Exhibition of deviation. These are further discussed in the light of perspectives drawn from the social sciences and feminist theories. One of the articles key arguments is that breast cancer campaigns, to a great extent, build upon and reinforce traditional, stereotypical gender roles.

Conflicting public health discourses—tensions and dilemmas in practice: The case of the Norwegian mother and child health service

In current Norwegian discourses and policy debates dealing with childrens health and well-being ideas of appropriate methods vary, as do ideas regarding the role parents play in the improvement of their childrens health. The present paper draws attention to these discourses, and it presents the findings of an empirical study that examined the everyday life of the Norwegian mother and child health service. The paper also addresses the dilemmas faced by practitioners as a result of expectations that they base their practice on inconsistent discourses. It argues that within this practical field there is a struggle for legitimacy between two sets of values, and that this in turn creates the dilemmas in question. The analysis is based on qualitative interviews with 30 Norwegian public health nurses.

Når det intime blir offentlig. Kvinners erfaringer med åpenhet om brystkreft

Det er i dag apenhet omkring tema som tidligere var private og tabubelagte, blant annet gjelder det sykdom og problematiske livsforhold. Den radende oppfatning er at apenhet pa disse omradene er til det gode. Helsemyndigheter og pasientforeninger oppfordrer til apenhet, men hva det innebaerer blir i liten grad diskutert. Sporsmal om private grenser og mulige negative konsekvenser som folge av apenhet er naermest fravaerende i offentlig helsedebatt. Denne artikkelen handler om hvordan brystkreftrammede kvinner har erfart apenhet omkring egen sykdom. Datamaterialet er skaffet til veie gjennom etnografiske intervju med 28 kvinner og avdekker positive erfaringer, som optimisme og sosial stotte samt negative, som mismot, paminnelser om doden og grensekrenkelser. Funnene blir analysert og diskutert med begreper som berorer privat/offentlig dimensjonen. Ettersom de negative erfaringene i stor grad viser seg a vaere knyttet til et grenseland mellom den private og offentlige sfaere, antyder vi eksistensen av en tredje sfaere, som vi kaller mellomsfaeren. Vi reiser sporsmal om en forskyvning av private anliggender ut i denne sakalte mellomsfaeren har bidradd til a viske ut skillelinjer mellom det private og offentlige og fort til at grenser for sosiale vaeremater blir uklare.